TITLE:
Postoperative Outcomes in Coblation versus Electrocautery Tonsillectomies
AUTHORS:
Viet Pham, Nikunj Rana, Michael Underbrink, Farrah Siddiqui, Shraddha Mukerji, Harold Pine
KEYWORDS:
Postoperative Outcomes; Coblation; Electrocautery; Tonsillectomies; Pediatric
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.3 No.1,
January
9,
2014
ABSTRACT:
Purpose: To
investigate whether children undergoing a tonsillectomy or adenotonsillectomy
(AT) with Coblation? will experience less postoperative pain and
return to a normal diet and a regular activity level sooner compared to the same procedure using
electrocautery dissection. This may manifest less school and work missed by the
child and caregiver, respectively. Materials and Methods: Seventy-four children
between the ages 2-13 years with either obstructive sleep apnea or
chronic tonsillitis were recruited at a single tertiary-care center from
January 2011 to November 2012 and underwent an AT via electrocautery or Coblation?.
Caregivers were given a ten-point Wong-Baker FACES pain scale and questions
inquiring the degree of oral intake, activity level, and impact on both the
child and caregiver in regards to missing work or school on postoperative days
(POD) 0, 1, 2, 3, 5, 7, and 14. Results: Children in the Coblation? arm required less pain medications (p 0.0049) on POD 0. Subsequent results were not significantly
different for any other day. Age- and gendered-controlled multivariate analysis
revealed a statistically significant difference in pain medications
administered (p 0.0001) but not pain scores (p 0.2115) between the two techniques, although this difference in
medications is likely related to the results observed on POD 0. There was no
incidence of postoperative hemorrhage in either group. Conclusions: While there
was less pain medication administered and slightly improved oral intake of
liquids on POD 0 for children in the Coblation? arm, there was no
difference in subsequent postoperative outcome or hemorrhage rates.